NPIMap

Organization Active NPI

Agoura Family Practice Associates

Doing business as Agoura Family Practice Medical Assoicates

  • Non-Pharmacy Dispensing Site
  • Thousand Oaks, CA
National Provider Identifier
1174995518
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
G69473 Issued in CA
Legal business name
AGOURA FAMILY PRACTICE ASSOCIATES
Doing business as
Agoura Family Practice Medical Assoicates
Practice address
3180 Willow LN
Suite 102
Thousand Oaks, CA 91361-4941
Phone
(805) 494-8520
Fax
(888) 431-8819
NPI assigned
Oct 26, 2015
Last updated
Oct 26, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
AGOURA FAMILY PRACTICE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bader Iqbal, M.D.NPI 1346254364
Title
Owner
Phone
(805) 494-8520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X G69473 CA Primary

Addresses

Primary practice location

3180 Willow LN
Suite 102
Thousand Oaks, CA 91361-4941

Mailing address

2980 N Beverly Glen Cir
Suite 100
Los Angeles, CA 90077-1726
Phone (310) 943-4180

Other names 1

  • Agoura Family Practice Medical Assoicates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Agoura Fam Prac2 organizations share this tax ID, including this one
Part of
Agoura Fam Prac

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1445817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445817600000",
    "number": "1174995518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2980 N BEVERLY GLEN CIR",
            "address_2": "SUITE 100",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900771726",
            "telephone_number": "310-943-4180",
            "fax_number": "888-431-8819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3180 WILLOW LN",
            "address_2": "SUITE 102",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913614941",
            "telephone_number": "805-494-8520",
            "fax_number": "888-431-8819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGOURA FAMILY PRACTICE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "AGOURA FAMILY PRACTICE ASSOCIATES",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A",
        "authorized_official_last_name": "IQBAL",
        "authorized_official_first_name": "BADER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "805-494-8520",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "G69473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Agoura Family Practice Medical Assoicates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Thousand Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.